NEW IMAGE BODY AND WELLNESS CLINIC, PC
Ambulatory Health at Elizabeth Lake Rd, Waterford, MI

License number
Michigan 06914E
Category
Ambulatory Health
Type
Primary Care
Owner
Name: MRS. BARBARA JEAN KACEL FNP-C
Title: FAMILY NURSE PRACTITIONER
Phone: (248) 682-6627
Address
Address
2590 Elizabeth Lake Rd, Waterford, MI 48328
National Provider ID: 1679523278
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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NEW IMAGE BODY AND WELLNESS CLINIC, PC

Waterford, MI

Status:
Inactive
Registration:
May 2, 2006
Addresses:
2590 Elizabeth Lk Rd, Waterford, MI 48328 (Physical)
Michigan (Mailing)
State ID:
06914E
Business type:
Domestic Professional Service Corporation
Expiration:
7-15-2009
Agent:
Rosalyn Thompson

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